Humeral Shaft Fracture Surgery

There are two main surgical options for treating a humeral shaft fracture: open reduction and internal fixation (ORIF) and intramedullary nailing (IMN).

Open Reduction and Internal Fixation (ORIF): This procedure involves making an incision along the length of the humerus to directly access the fracture site. The surgeon then aligns the broken bone fragments into their correct anatomical positions, a process known as “reduction.” The fragments are held together using metal plates and screws that are affixed to the exterior of the bone, hence the term “external fixation.”

Intramedullary Nailing (IMN): Unlike ORIF, IMN does not require a large incision. Instead, a long metal rod is inserted into the marrow canal of the humerus. This rod provides internal support and alignment for the fracture as it heals, hence the term “internal fixation.”

Expected Surgery Outcome

With successful surgery and appropriate aftercare, patients can expect significant improvement in their pain levels and overall arm function. Both ORIF and IMN techniques aim to ensure the fractured humerus heals in the correct anatomical position, enabling patients to regain most, if not all, pre-injury range of motion and strength.

Potential surgery complications and risks

As with any surgery, humeral shaft fracture surgeries carry the risk of complications, including infection, nerve damage, blood clots, adverse reactions to anaesthesia, nonunion, malunion, and hardware complications.

Risks

  • Infection: Infections can occur at the surgical site and may require additional treatment.
  • Nerve Damage: The radial nerve, which runs along the humerus, may be injured during surgery.
  • Blood Clots: Due to immobility, there’s a risk of blood clots forming in the arm veins.
  • Nonunion or Malunion: The fracture may not heal (nonunion) or may heal improperly (malunion), causing persistent pain and functional limitations.
  • Hardware Complications: The plates, screws, or rods used in surgery may cause discomfort or fail, necessitating further procedures.

Recovery after surgery

Post-operative care for a humeral shaft fracture typically involves immobilising the arm in a sling or cast and starting pain management medication immediately. Physiotherapy commences within a few weeks to gradually restore strength and range of motion. Full recovery timelines vary widely based on the surgery type and the patient’s general health but generally span from several months to over a year.